Innovations for Safety

In the mid-1940s, manufacturers of children's aspirin began to add flavoring to it so sick children would take it more readily. However, an unexpected consequence of this action resulted in children being more likely to simply eat the medicine during unsupervised moments, as if it were candy.

Disturbed by the number of sick and dying patients who were coming to the hospital from overdoses of “candy aspirin,” Dr. Arena called Mr. Abe Plough, president of the company producing St. Joseph's aspirin. Dr. Arena wanted to implore that some preventative action be taken and suggested that the company manufacture a special new top for the product that parents could open but children could not. Thus the idea for the childproof safety cap was born.

The St. Joseph Company undertook action to create a safety cap device and enlisted Dr. Arena to help test design variations before the product went to market. The St. Joseph Company, the Homemaker's Guild, Dr. Arena, and other physicians nationwide began to study the efficacy of the new safety cap. Both children and their parents were tested. The resulting survey was published in the Journal of American Medical Association. Thanks to the survey results, St. Joseph's aspirin became the first product sold in a container with a safety cap.

Dr. Arena would later work closely with Mr. Plough on other ways of reducing hazards for children, such as decreasing the tablet dosage in children's aspirin.

“The adoption of such a closure could mean a saving of many small children's lives from the accidental ingestion of drugs…”
Jay Arena, 1957, letter to fellow physicians

In 1952, the American Academy of Pediatrics initiated a physician's survey to determine the major causes of accidents in children. As a member of the Academy's Accident Prevention Committee, Dr. Arena predicted that the results would favor accidental poisonings, and he was correct as appproximately 50 percent were due to this reason.

Dr. Arena then shared with his colleagues the recording methods he had been developing at Duke. Very soon afterwards, a hospital in Chicago began to implement Dr. Arena's methods and was the first to adopt the nomenclature of “Poison Control Center.” In 1954, Duke adopted the title and called itself the second Poison Control Center in existence.

The Duke Poison Control Center received calls and letters from people with emergencies or questions regarding poisonings. Examples of calls included those from parents of children who had swallowed hazardous household products or adults who had drunk toxic substances stored in inappropriately labeled containers. Due to their frequent contact with insecticides, farmers and farmworkers were often in need of assistance in the summertime.

Other requests about poisons included investigations into certain wild berries, lead in the piping of moonshine stills, and drug combinations for a local physician's patient who had tried to commit suicide. In the case of serious calls, the Poison Control Center would often give initial advice as to the substance ingested and then direct the caller to contact a local physician for treatment since the Center itself was not a treatment facility.

In 1954, the Center received 154 calls. By 1983, there were approximately 6,000 calls per year with 1,000 additional people personally writing to or calling the Director of the Center.

Many written requests for information came from students doing projects on poisoning or safety topics.

Poison Control Center
Duke Hospital
Durham, NC
Dear Sirs:
I am a seventh grader. My project is to write to you for some information on safety. Please send it soon.

Other letters came directly from physicians.

Director
Poison Control Center
Duke Hospital
Durham, NC
Dear Sir: Please send any available information about cadmium poisoning through inhalation. A welder patient of mine was recently hospitalized because of a severe headache and marked hypertension and he suspects that his occupation may have been a factor in this temporary disability.

Sometimes the letters came with rather unusual questions.

Shirley K. Osterhout, M.D.
Assistant Director
(Duke Poison Control Center)
Duke University Medical Center
Durham, NC (27706)
Dear Sirs:
Are you equipted to analize Honey, to see if it has been sprayed with a poison or spray, making it unfit for Human use?
About three weeks ago, my bees started dying around 10 to 15 Bee hives and a bunch of bees was sent to State College at Raleigh to be examined. We have not had a report on these as yet, but my greatest concern, is the Honey, as the whole Honey crop was on the hives- moisture was found at the mouth of the Hives and I would like to have the Honey analized before using any-
Please advise if this Honey can be tested for poison, if I send a sample to you. If this is not in your department, Please advise us where to send it. If there is a charge to analize Honey for poison, please quote the price-

Dr. Osterhout responded to this letter that the Duke Poison Control Center could not analyze his honey, but she did provide him with information about places that might be able to do so.

In 1984, the Duke Poison Control Center was officially certified by the American Association of Poison Control Centers. The requirement that poison specialists staff the Center 24 hrs. a day officially ended the pediatric residents’ involvement in the Center.